乙型肝炎表面抗原阳性对妊娠期肝内胆汁淤积症及围产期母婴结局的影响  

Effect of HBsAg-positive on Intrahepatic Cholestasis of Pregnancy and Perinatal Maternal and Infant Outcomes

作　　者：刘薇 吴开奇 LIU Wei;WU Kai-qi(Department of Clinical Laboratory,the Affiliated Obstetrics and Gynecology Hospital,Zhejiang University School of Medicine,Hangzhou 310006,Zhejiang,China)

机构地区：[1]浙江大学医学院附属妇产科医院检验科,浙江杭州310006

出　　处：《医学信息》2023年第22期73-77,共5页Journal of Medical Information

摘　　要：目的探讨乙型肝炎表面抗原阳性对妊娠期肝内胆汁淤积症(ICP)及围产期母婴结局的影响。方法选择2018年1月-12月于我院住院分娩的1173例乙型肝炎表面抗原携带孕妇作为HBsAg阳性组,另选取同期19838例无乙型肝炎表面抗原携带孕妇作为HBsAg阴性组,比较两组年龄、孕前体重指数、剖腹产史、经产妇、试管婴儿、流产史、双胎、ALT>40 U/L及ICP发生率,Logistic回归分析HBsAg阳性与ICP发生风险的关系,并进一步比较ICP合并HBsAg阳性孕妇和单纯ICP孕妇围产期母婴结局。结果HBsAg阳性组年龄、经产妇、试管婴儿、流产史及双胎比例和ICP发生率均高于HBsAg阴性组,差异有统计学意义(P<0.05);单因素和多因素Logistic回归分析显示,HBsAg阳性会增加ICP的发生风险,并且双胎、试管婴儿也是ICP发生的独立危险因素;ICP合并HBsAg阳性孕妇剖腹产、早产发生率高于单纯ICP孕妇,差异有统计学意义(P<0.05)。结论妊娠期HBsAg阳性可增加ICP的发生风险,并且会增加ICP孕妇早产和剖宫产的发生率。Objective To investigate the effect of HBsAg-positive on intrahepatic cholestasis of pregnancy(ICP)and perinatal maternal and infant outcomes.Methods A total of 1173 pregnant women with hepatitis B surface antigen who were hospitalized in our hospital from January to December 2018 were selected as the HBsAg-positive group,and 19838 pregnant women without hepatitis B surface antigen were selected as the HBsAg-negative group.The age,pre-pregnancy body mass index,history of caesarean section,multipara,test-tube baby,abortion history,twins,ALT>40 U/L and the incidence of ICP were compared between the two groups.Logistic regression was used to analyze the relationship between HBsAg positive and the risk of ICP.The perinatal maternal and infant outcomes of ICP combined with HBsAg positive pregnant women and simple ICP pregnant women were further compared.Results The age,multipara,IVF,abortion history,proportion of twins and incidence of ICP in HBsAg-positive group were higher than those in HBsAg-negative group,and the differences were statistically significant(P<0.05).Univariate and multivariate logistic regression analysis showed that HBsAg positive increased the risk of ICP,and twins and IVF were also independent risk factors for ICP.The incidence of cesarean section and premature delivery in ICP combined with HBsAg positive pregnant women was higher than that in ICP pregnant women,and the difference was statistically significant(P<0.05).Conclusion HBsAg-positive during pregnancy can increase the risk of ICP,and will increase the incidence of preterm birth and cesarean section in ICP pregnant women.

关 键 词：妊娠期肝内胆汁淤积症 乙型肝炎表面抗原 母婴结局 

分 类 号：R512.6[医药卫生—内科学]